Priorized services and waiting time reduction: proposal for improvements in an emergency service

Abstract

Organizations of various sectors and activities have sought to implement improvements in their processes based on the concepts of lean philosophy. This research aimed to analyze the service times of patients who get in the Alfa General Hospital and propose alternatives to reduce the waiting time until the doctor's appointment. Waiting times between 2017 and 2019 were evaluated, using the Manchester Triage Protocol as a reference. A total of 167,743 service records were verified, showing that there was no statistical difference in waiting times in situations classified as emergency, very urgent and urgent. It was also observed the prevalence of care for patients with intermediate risk (approximately 84.43%). It was inferred that this fact, in turn, may be overloading the medical and nursing structure, as well as preventing priority cases from being treated in a shorter time. Based on these data, using the 5W2H methodology, improvements were proposed in order to keep the hospital medical structure available for the most serious cases and reduce emergency and - above all - emergency care times. Among the contributions are the approach to problems that directly or indirectly impact all those who need reception and care in hospital emergency rooms and the expansion of possibilities to identify potential causes of long waiting times in similar situations. Failure to consider situations related to the COVID-19 pandemic represents one of the limitations of the research.

Key-words: lean healthcare; urgency and emergency; hospital; waiting lines.